Contraception: Abortion

Abortion is a topic that is always tricky to discuss. Conversations tend to be loaded with misconceptions and intense emotional feelings can override intelligent discourse.

RU-486

This pill is a little more controversial than the previously discussed morning after pill. The brand name is Mifeprex, and unlike the morning after pill, it is an abortifacient. It is an alternative to the more invasive surgical abortion.

Mifeprex can be taken after a positive pregnancy test to chemically abort the fetus, but it can only be taken up to 49 days after the first day of your previous period. Its active ingredient is a steroid that works to block the hormone progesterone. Without the progesterone, the uterine lining will start to break down and shed, just like in a normal period. Mifeprex is often taken in conjunction with a chemical that will help your cervix open and allow the tissue to shed.

Mifeprex cannot be taken without a prescription, and it requires at least one follow-up visit to your doctor to ensure that the pill worked correctly. It causes heavy bleeding and cramping, but any other side effects should be immediately discussed with a doctor.

Abortion

Thanks to the landmark case of Roe v. Wade in 1973, women in the US are able to legally receive an abortion to terminate an unwanted pregnancy. There remains a lot of controversy over this decision, and there are new court cases challenging the legality of this case all the time.

According to Wikipedia, an abortion is defined as the termination of pregnancy by the removal or expulsion from the uterus of a fetus or embryo prior to viability. This means that the fetus or embryo is not developed enough to survive outside of the womb. I recommend looking at the Wikipedia page for descriptions on how abortions work, because there are too many ways for me to explain them all here.

I personally believe in the right of a woman to choose whether or not she wants to carry a pregnancy to term. Before Roe v. Wade, there were women getting abortions from people who were not licensed to practice medicine, and in unsafe and unsanitary conditions.

These things still happen in areas that do not legally allow abortion. Due to unsanitary conditions or the lack of medical knowledge by the person providing the abortion, many women die due to sepsis or hemorrhaging of their uterus.

Despite any moral or religious objections regarding abortion, surely everyone can agree that if a woman is seeking to terminate a pregnancy, she should have access to a trained doctor who will perform the surgery in a clean and antiseptic environment, right?

I had a patient who took this pill and had horrible bleeding afterwards. She was at the 9 week mark when she took it, but I ended up researching it because I didn’t even know it existed. You can buy it under the table on websites basically so if you live in a place where abortion is illegal, this is an easy way to abort. Also, there’s no way to tell if it was a spontaneous abortion or not if you take the pill, so if there are issues, the girls can still seek medical treatment for hemorrhaging if needed. Interesting pill. I’m a big supporter of abortion (however, NOT if somebody uses it repeatedly instead of just using some birth control!!!).

I would think that anyone who regularly uses RU-486 or surgical abortion instead of regular birth control has other issues that need to be addressed. There could be psychological reasons that they are unable (or unwilling) to take hormonal birth control. Abortion is a much more invasive, painful, and emotionally intense form of contraception and I honestly do not think there are many people who would rather have multiple abortions instead of using some other form of contraception.

Well, working in a busy ER, I’m shocked and appalled by the amount of young women who repeatedly have abortions. One girl the other day told me she didn’t need any further medical care because she wasn’t keeping this baby, after she had just had an abortion in November. Her reason for not using birth control? She said her doctor took her off because she had an adverse reaction to the pill. Why other methods weren’t discussed any point is beyond me (or else she just didn’t listen- after all, 19 year olds know everything). Sadly, I see it time after time. I look at people’s history and see “has had 3 abortions” and it’s just kind of sickening, especially because they usually don’t have kids and are messing up their reproductive organs for the future. Even if they can’t take a hormonal birth control of any type (which between the pill, Implanon, IUDs, Nuvaring, there should be something that works), there are always CONDOMS. But when asking these multiple abortioners if they’ve been using any protection, obviously the answer is always no…

Not at all. I love and appreciate any and all engaging feedback on my posts. I am surprised at your experiences. How tragic for these young women, and how irresponsible of their primary physician for not recommending other options, like the IUD!